A randomized controlled trial of telemedicine and e-health interventions for the management of oral complications in oncology patients undergoing antineoplastic therapy

Background Severe oral complications during and after antineoplastic therapies, such as mucositis, fungal, viral, and bacterial infections, xerostomia, dysphagia, and jaw osteonecrosis, significantly impair oral health and quality of life in oncology patients. Dentist involvement throughout oncology care is essential to reduce complications and support patient well-being. Telemedicine and e-health tools offer effective approaches for oral-health monitoring during treatment. Objective To evaluate the effectiveness of a comprehensive dental intervention for the assessment and management of oral health in patients with solid tumors during cancer therapy using e-health applications, compared with standard oncology-based oral care. Methods This prospective randomized interventional study was conducted at an Oncology Hospital in Athens (March 2022–November 2023), including 105 patients with breast, lung, or colon cancer initiating chemotherapy or combined therapy. Three clinical and radiographic oral-health and quality-of-life assessments were performed. The control group received standard recommendations to visit a dentist, while the intervention group followed a structured, individualized oral health - management protocol via telemedicine and clinical monitoring. Results Telemedicine significantly improved oral-health outcomes and oral-care behaviors compared with controls. At mid-treatment and treatment completion, the intervention group showed statistically significant lower rates of mucosal lesions, gingival bleeding, gingivitis, dental caries, periodontitis, and higher tooth-brushing frequency. These results indicate that Telemedicine and e-health enable effective monitoring, early-stage detection, and oral self-care guidance, improving oral health and well-being during and after treatment. Conclusion Integration of structured teledentistry monitoring into oncology care was associated with improved oral health outcomes in patients undergoing antineoplastic therapy, compared with usual practice.